Good Samaritan Society - Grand Island Village

In the surveyor’s words

From the most serious findings on record at Good Samaritan Society - Grand Island Village, in the surveyor’s own words.

• Actual harm, patternF725May 18, 2022

  Licensure Reference Number 175 NAC 12-006.04C Based on observation, interview, and record review, the facility failed to ensure sufficient staff to care for residents in the Cottonwood Unit of the facility. This failure resulted in a resident waiting over 2 hours for pain medication, residents not being assisted with meals or ADLs (Activities of Daily Living), residents with pressure ulcers not being assessed or provided treatments as ordered by their physicians, and residents waiting extended periods of time for call lights to be answered. This affected 32 of the 46 residents that resided in the facility. The findings are: A. […]

• Actual harm, isolatedF689Sep 26, 2024

  Licensure Reference Number 175 NAC 12-006.09(I) Based on observation, interview, and record review; the facility failed to use the correct sling size to transfer a resident, and failed to asses and monitor a resident after a fall for 1 (Resident 6) of 3 sampled residents. The facility census was 41. Findings are: Record review of Resident 6's Census List revealed Resident 6 admitted to facility of 06/14/2024 with the following diagnoses: acquired Absence of left leg above knee (a surgical procedure that removed part of the leg), encephalopathy ( a general term for brain disorders or diseases), sepsis (a serious condition when the body's immune system overreacts to an infection or injury), Type 2 Diabetes Mellitus (condition when the body develops insulin resistance and can result in high… […]

• Actual harm, isolatedF686Dec 13, 2022

  LICENSURE REFERENCE NUMBER 175 NAC 12-006.09D2a Based on observation, record review and interview; the facility failed to implement interventions for (Moisture Associated Skin Damage) MASD (skin erosion caused by prolonged exposure to a source of moisture) and shearing ( pressure and friction, injuring the skin at the same time) for Resident 3 which resulted in a stage III (involves full-thickness of the skin) pressure ulcer. The facility staff identified a census of 37. The findings are: Review of the (Catholic Health Initiative) CHI Wound Note for Resident 3 dated 11/30/22 revealed the following: -To the left buttocks the stage III pressure ulcer measures 0.5X0.5cm (centimeter) and is complicated by shearing with crusting and pealing skin to the direct periwound skin and light maceration… […]

• Actual harm, isolatedF686May 18, 2022

  Licensure Reference Number 175 NAC 12-006.09D2b Based on observations, interviews, and record review, the facility failed to evaluate pressure sores and provide treatment to aid in healing of pressure sores for 2 (Resident 1 and 3) of 11 sampled residents. The facility had a total census of 46 residents. Findings are: A. Observation on 5/16/22 at 7:15 PM revealed a wound vacuum in place on Resident 1's right buttock. A review of Wound Data Collection record dated 1/2/22 for Resident 1 revealed it was the initial data collection sheet for right buttock wound. The wound was measured as having a length of .75 cm [centimeters], a width of .5 cm, and a depth of .75 cm. […]

• Actual harm, isolatedF692May 18, 2022

  Licensure Reference Number 12-006.09D8b Licensure Reference Number 12-006.09D9 Based on observation, interview, and record review, the facility failed to implement interventions to prevent a significant weight loss for 1 (Resident 3) of 4 residents reviewed. The facility also failed to ensure water was available for 1(Resident 3) of 7 sampled residents. The facility had a total census of 46 residents. The findings are: A. A review of Resident 3's medical record revealed an admitted [DATE]. A review of Resident 3's listed MDSs (Minimum Data Set - a federally mandated assessment tool used for resident care planning) revealed a significant change MDS was completed for Resident 3 on 4/25/22. […]